The department has also taken no action in cases where insurance carriers allegedly provided false or misleading information to the federal government to terminate medical benefits for injured civilians–another potential crime under the law, known as the Defense Base Act [2].

The lack of enforcement has allowed carriers and contract companies to abuse the system by avoiding or blocking payments, forcing contractors to spend months and sometimes years battling carriers in court for benefits, claimants and their attorneys said.
[…]
But the ProPublica examination shows that the department has rarely deployed the tools available under the law to crack down on fraud and abuse–a record that extends back through Democratic and Republican administrations. Labor officials can recommend cases for prosecution to the Justice Department–but have only done so once in the past two decades, according to Labor officials.

They can directly levy civil penalties, but have done so sparingly. As of June, Labor officials have imposed fines in only about 50 of more than 36,000 cases processed by the two largest insurance carriers, according to an internal Congressional memo [3] obtained by ProPublica.
[…]
Passed in 1941, the Defense Base Act requires every company with an overseas U.S. contract to obtain health insurance for its workers. But no single U.S. agency is fully in charge of implementing the program, which has exploded since the wars in Iraq and Afghanistan. More than 1,600 civilians have died and 37,000 have reported injuries.
[…]
"We put our lives in danger for our military. We supply them with water, food, ammunition, housing. And yet, we’re screwed," said Philemon, an Air Force veteran. "I almost give my life for my country and I get treated like dirt? "Something’s not right with that picture," he said.